Individual
KIRK PATRICK SHEA I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
91 ARIES LN, LA GRANDE, OR 97850-3309
(541) 963-8678
Mailing address
91 ARIES LN, LA GRANDE, OR 97850-3309
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
08979
OR
Other
Enumeration date
01/16/2018
Last updated
01/16/2018
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